Provider Demographics
NPI:1366684979
Name:RIGSBY PROUSALIS, TINA A (ARNP)
Entity Type:Individual
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First Name:TINA
Middle Name:A
Last Name:RIGSBY PROUSALIS
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:4601 CHARLOTTE PARK DR.
Mailing Address - Street 2:SUITE 390 HEALTH STAT
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217
Mailing Address - Country:US
Mailing Address - Phone:704-529-6161
Mailing Address - Fax:704-831-6097
Practice Address - Street 1:701 TALLEVAST RD.
Practice Address - Street 2:SUN HYDROLICS
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243
Practice Address - Country:US
Practice Address - Phone:941-362-1300
Practice Address - Fax:941-362-1349
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2009-06-17
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Provider Licenses
StateLicense IDTaxonomies
FL2680462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2680462OtherA.R.N.P. STATE OF FLORIDA DEPARTMENT OF HEALTH